Healthcare Provider Details

I. General information

NPI: 1346054335
Provider Name (Legal Business Name): ZION NOVA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 02/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 W CHESTNUT AVE
MONROVIA CA
91016-3318
US

IV. Provider business mailing address

320 W CHESTNUT AVE
MONROVIA CA
91016-3318
US

V. Phone/Fax

Practice location:
  • Phone: 909-896-5360
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KUAN CHANG CHEN
Title or Position: MEMBER
Credential:
Phone: 909-896-5360